Is it hot in here, or is it just me?

So I'm pretty sure most of you in the US have noticed the heat wave. For those of us on the lower half of the Eastern seaboard (hell, even the upper half), it's downright brutal. On Monday, I was stuck on a commuter train out of DC for two hours, crammed into a space that even a sardine would have found cozy. It was also the one car on the train without air conditioning. By the time I arrived home, I was a little unsteady on my feet. My sundress was soaked with sweat.* My face was flushed. I was exhausted.

I spent the evening collapsed in a heap on the sofa, engaging in some trashy Grey's Anatomy therapy, and I drank down a half gallon of iced sweet tea.

All was ultimately well.

I had avoided heat sickness and heat stroke. Lord only knows how close I came. Closer than I ever wanted, however. But I was lucky. I recognized that I was overheating and did what I could. I (of course) had no water with me to drink, but I chugged a lot when I got home. I took a cold shower. The problem is this: heat stroke is an anosognostic condition. You stop realizing you're at risk. You're "fine." Maybe a little warm, but "nothing to be concerned about."

Sound familiar?

New York Times health blogger Tara Parker-Pope** wrote a piece the other day on heat illness, in which she said that denial is a common symptom. Is it really denial, or is it an inability to see that one is overheated? There is a difference, however subtle and however unobservable to most outsiders. Denial means you know there is a problem, you just won't admit it. Anosogosnia means that you literally don't know that there's a problem. Not only that you don't know but that you can't know. The very illness you're supposed to be aware of prevents you from knowing that you have that same illness.

Yet we are all encouraged to watch out for our elderly neighbors and young children who may get overheated. "It doesn't matter if they deny they are too hot," we are told. "Get them out of the heat anyway."

Why don't people say that with eating disorders? Why aren't we encouraged to get sufferers to eat, even if they don't think they need to? Someone at risk for heat stroke might be perfectly coherent on all other issues except their inner body temperature--and we still get them out of the sun and into the air conditioning. Someone with an eating disorder might be perfectly coherent about school and feng shui--and we still need to get them to eat.

No one says that someone with heat stroke just needs to control their own body temperature a bit. Of course, educating them about such dangers after they've cooled off makes a whole heaping load of sense. But if you try to convince someone with heat stroke to get out of the heat, you will be told that you are wasting valuable time. Don't pass go, don't collect $200. Get that person into the shade. Now.

If we can do it with heat, why not food?

*Thank you, everyone nearby me on that train, especially the person into whose armpit I was so unceremoniously jammed, for the liberal use of deodorant. I commend you all.

**My opinion on her blog is mixed. Her writing skills are there, but I don't always agree with her coverage.

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Libby said...

Oh, you poor thing! Hasn't this heat just been awful?? I swear, I was never so glad to see rain in my whole life as I was last night.

elizabeth said...

Really? I'm not jealous but I suppose I am a little oblivious. It has been raining and raining and raining and in the 50's here (seattle) Could I trade you a little rain for a little sunshine?

VickyAnn said...

Wise words.

It's been similar in the UK, I hate the commute to work cramped into London's underground system, you're basically trapped. But today the temperature has dropped and it's raining again!


Fiona Marcella said...

can someone tell me how to pronounce anosognostic . I've often wanted to shout it at people in psychiatry who really don't seem to get it but can't as yet without making a fool of myself because I don't know how to say it.

mary said...

My dad always said to take a warm shower to help the body during high heat. For some reason it works best if the water temp is higher than the miserable heat. It makes sense to me.
The heat wave has broken here for a brief respite but it's coming back tomorrow.
Any chance you can work from home?

Marcella, there are some words we are best not knowing how to pronounce!

emmy. said...

ok, now, here's the place where i openly admit that i am, in fact, crazy.

i have been loving that heat wave. and i don't own a/c. i sit in my early-20-something-esque apartment in a sports bra and an article of clothing that barely constitutes a full pair of shorts with a frozen washcloth on my neck and a fan blowing on me... and while that may come across to some as miserable, i am in love.
my roommate even offered to bring in her a/c from home and i declined.

however, i have become a little (more) dehydrated.. a mix of ice, gatorade and water is highly recommended.

and, finally, (i know this comment is getting lengthy) marcella's comment made me laugh :) all i know is that the "g" is pronounced like "gag". otherwise, i don't think i know how to say it, either lol.

stay hydrated, everyone!!

Unknown said...


I'm tickled to brag that I taught it to a leading psychiatrist and he loved it.

I started using it after hearing it used in the bipolar world.

I pronounce it an - oh - sog - NO - sick.

Carrie Arnold said...


By all means, let's swap climates for a day or two.

And I bow to Laura's superior pronunciation skills. I myself spent all day doing tongue yoga with organic chemistry research I was writing about.

Pronunciation guides are also on, and I think anosognostic is in there.

Carrie Arnold said...

Is the geek in me coming out now that I realize that "gnosis" is in that word? And that I'm thrilled I realize it? And know it comes from the Greek for "knowledge"?

I'm going to go with yes.

Fiona Marcella said...

It's the gnostic bit that confuses me with the pronunciation - but I'll go with Laura's advice. It would probably have been wasted on the first psychiatrist I wish I'd tried it on, as he couldn't even pronounce the therapist's (perfectly ordinary) name, but I'm going to use it on one or two others when I see them.

Harriet said...

Coming late to the party as usual, but this is a great post, Carrie. I feel exactly the same way. (About the heat, too!) It makes me feel physically ill to not say something to someone obviously suffering from an eating disorder. I literally walked out of a store recently because the saleswoman was clearly anorexic. I was shaking with feelings and things I wanted to say. But there is no socially acceptable way to say any of it.

Carrie Arnold said...


No I agree with you about the "g". I tried looking on but I couldn't see the little graphics that told you how to pronounce the word phonetically. Considering that, Laura's expertise, and my bad natural talent at spelling (I'm good because I practice- it's not a natural skill), I will bow to Laura's pronunciation. And blame her if I sound stupid. :)


I definitely understand your frustration- and hers. I try to look at it as trying to reason with someone who's high on heroin. They are incapable of logic. There's not much you can say or do if you aren't close enough when they're NOT using.

Rod said...


It's just not feasible that more warmth will lead to cooling. It's simply physics -- if you add heat, you will get hotter.

Your dad fell victim to a common wives' tale: add heat to cool things and cold to warm things.

Stay out of the heat when you're hot, or you'll likely find yourself in the emergency department.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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